- Molina Healthcare (FL)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- Centene Corporation (Tallahassee, FL)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... perspective on workplace flexibility. **Position Purpose:** The Pharmacy Resolution Specialist receives and responds to calls from members, provider/physician's… more
- CVS Health (Tallahassee, FL)
- …each and every day. **Position Summary** The **Senior Accounts Receivable Specialist ** prepares accounting and financial records and reports, including general ... monthly invoices in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required Qualifications** + 2+… more
- Devereux Advanced Behavioral Health (Orlando, FL)
- …and adults whose needs are extra ordinary. As a Contracts / Managed Care Specialist , you will: + Distribute monthly rosters to programs for updates on new hires, ... MMAs. + Coordinate with contract representatives and network providers to resolve claims issues. + Facilitate the credentialing process for new programs joining MMAs… more
- Molina Healthcare (FL)
- …to state and federal and Molina Healthcare guidelines. + Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research. + ... and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. + Assists...**C** **E:** + 1 year of Molina experience, health claims experience, OR one year of customer service/provider service… more
- Cognizant (Tallahassee, FL)
- Cognizant is seeking an IBM i (AS400) Infrastructure Specialist to support the IBM i infrastructure for RxClaims. This position will perform level 1 monitoring of ... health monitoring of: Claim adjudication jobs, ASP alerts, CPU alerts, Claims queue monitoring, Storage monitoring, Connect Direct subsystem. + Contact different… more
- Citigroup (Miami, FL)
- The Telesales Specialist role is a Client Service and Sales support position responsible for servicing and supporting internal and/or external clients primarily ... associate and will be treated with a closed loop process. + Ensures customer claims and complaints are handled in accordance with FINRA and firm policy. + Ensures… more
- Command Investigations (Lake Mary, FL)
- …business located in Lake Mary has an immediate need for a full-time Data Entry Specialist . In this role, you will be responsible for case referral intake from our ... written and verbal communication skills + Basic understanding of claims vocabulary + Investigative mindset (questioning the out of...High School diploma Benefits Include: + Full-time employment + Medical , dental and vision insurance + 401K + PTO… more
- Robert Half Accountemps (Miami, FL)
- …partners and internal teams to resolve customer concerns effectively. * Process claims , invoices, and enrollment requests with accuracy and efficiency. * Ensure ... suppliers, and internal teams. * Familiarity with billing, invoicing, and claims processing procedures. * Excellent communication skills, both verbal and written,… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …completion, Hospital privileges verification, System Award Management (SAM), Claims history, Accreditation (ancillary facilities), Site Visits and obtaining ... OIG reports, SAM report, Board certification, Hospital privileges verification, claims history, Accreditation (ancillary facilities), and obtaining additional information… more